<?php /* SVN: $Id: $ */ ?>
<div class="paypalAccounts form">
<div class="l-curve-top">
		<div class="r-curve-top">
				<div class="top-bg"></div>
		</div>
						</div>
     <div class="shad-bg-lft clearfix">
							<div class="shad-bg-rgt">
								<div class="shad-bg">
<div class="main-section contacts-form round-5">
<?php echo $this->Form->create('Payment', array('action' => 'create_paypal_account', 'class' => 'normal'));?>
	<fieldset>
 		<h2 class="paypal-heading clearfix"><span><?php echo __l('Create'); ?></span><span class="paypal-icon">PayPal</span><span><?php echo __l('Account');?></span></h2>
		<div class="content-info clearfix">
		<p><?php echo __l('Here you can create PayPal account quickly (through PayPal API).');?></p>
		<p><?php echo __l('You may also create a PayPal account from ').$this->Html->link(ConstPaymentGatewaysName::PayPal, $referralURL, array('target' => '_blank')).__l(' site.'); ?></p>
		</div>
	<?php		
		echo $this->Form->input('PaypalAccount.first_name');
		echo $this->Form->input('PaypalAccount.last_name');
		echo $this->Form->input('PaypalAccount.email');
		echo $this->Form->input('PaypalAccount.user_id',array('type'=>'hidden'));
	?>
	<div class="input date required">
		<div class="js-datetime">
			<?php echo $this->Form->input('PaypalAccount.dob', array('label' => __l('DOB'), 'div' => false, 'empty' => __l('Please Select'), 'maxYear' => date('Y') - 15, 'minYear' => date('Y') - 115, 'orderYear' => 'asc')); ?>
		</div>
	</div>
	<?php
		echo $this->Form->input('PaypalAccount.address1');
		echo $this->Form->input('PaypalAccount.address2');
		echo $this->Form->input('PaypalAccount.city');
		echo $this->Form->input('PaypalAccount.state');
		echo $this->Form->input('PaypalAccount.paypal_country_id', array('empty' => __l('Please Select'), 'label' =>__l('Country')));
		echo $this->Form->input('PaypalAccount.paypal_citizenship_country_id', array('empty' => __l('Please Select'), 'label' =>__l('Citizenship Country')));
		echo $this->Form->input('PaypalAccount.zip');		
		echo $this->Form->input('PaypalAccount.phone');
		
	?>
	</fieldset>
	<div class="submit-block clearfix">
<?php echo $this->Form->end(__l('Create PayPal Account'));?>
</div>
</div>
</div>
</div>
</div>
<div class="l-curve-bot">
		<div class="r-curve-bot">
				<div class="bot-bg"></div>
		</div>
						</div>

</div>
